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目的了解妊娠期高血压疾病患者焦虑情绪的分类特点及不同类别间服药依从性的差异。方法使用焦虑自评量表(SAS),8条目Morisky服药依从性量表(MMAS-8)对湖南省郴州市213例妊娠期高血压疾病患者进行调查。结果妊娠期高血压疾病患者的焦虑状况可以分为焦虑症状高发组(21.1%)、乏力-失眠组(49.3%)和情绪平稳组(29.6%)3个潜在类别。Logistic回归分析结果显示,与情绪平稳组相比,焦虑症状高发组中受教育程度在大专及以上、无规律产检和有蛋白尿者所占比例更大;乏力-失眠组中无分娩经历者所占比例更大。有无规律产检、家庭人均月收入和有无分娩经历是影响妊娠期高血压疾病患者服药依从性的主要因素(P<0.05)。焦虑症状高发组Morisky服药依从性量表得分低于乏力-失眠组和情绪平稳组(4.84±1.63比5.83±1.53,5.81±1.10,F=9.071,P<0.01),乏力-失眠组和情绪平稳组服药依从性得分差异无统计学意义(P>0.05)。结论妊娠期高血压疾病患者的焦虑状况有明显分类特征,不同潜在类别中受教育程度、有无规律产检和有无分娩经历者有着不同分布。应及时关注和干预焦虑症状高发组、高学历、无规律产检和无分娩经历的孕妇,以改善其焦虑情绪和服药依从性。
Objective To investigate the classification characteristics of anxiety in patients with hypertensive disorder complicating pregnancy and the differences in medication adherence among different categories. Methods The anxiety self-rating scale (SAS) and morisky medication adherence scale (MMAS-8) were used to investigate 213 cases of hypertensive disorder complicating pregnancy in Chenzhou, Hunan Province. Results Anxiety status of patients with hypertensive disorder complicating pregnancy can be divided into three potential categories: high incidence of anxiety (21.1%), fatigue-insomnia (49.3%) and emotional stability (29.6%). Logistic regression analysis showed that, compared with the emotion-stable group, the prevalence of education in college students with high anxiety symptoms was higher than that of college students, with a higher proportion of irregular clinical examination and proteinuria; and those with no childbirth experience in the fatigue-insomnia group A larger proportion. Whether there is regular inspection, per capita monthly household income and whether or not the birth experience is the main factor affecting medication compliance in patients with gestational hypertension (P <0.05). Morisky medication compliance scale of high anxiety symptom group was lower than that of fatigue-insomnia group and emotional stability group (4.84 ± 1.63 vs 5.83 ± 1.53,5.81 ± 1.10, F = 9.071, P <0.01), fatigue-insomnia group and emotional stability Group medication compliance scores showed no significant difference (P> 0.05). Conclusions The anxiety status of patients with hypertensive disorders in pregnancy has obvious classification features. There are different distributions of education in different potential categories, with or without regular birth control and with or without childbirth experience. Should pay close attention to and intervention in the high incidence of anxiety symptoms, highly educated, irregular maternal and childbirth experience pregnant women to improve their anxiety and medication compliance.